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Solve the Medical Riddle: Her Broken Bone Isn’t Healing, Third Week

Editor’s note: Welcome to our ThirdAge feature that gives you a chance to play medical sleuth as we share the details of what happened when a patient presented with a problem that stumped the physician at first.

The first week of this riddle, the patient reported her symptoms to her PCP. The doctor proceeded with the examination using the classic S-O-A-P notes as follows:

S=Symptoms or Chief Complaint

O=Objective Findings

A=Assessment or Analysis

P=Treatment Plan or Recommendations

Last week, we learned that Kathy has indications of autoimmune disease and that she has high potassium and blood urea nitrogen levels as well as low sodium and cortisol levels. She also has bone loss called osteoporosis. This week, we’ll let you know what some people have suggested as possible diagnoses. Next week, the doctor will reveal the actual diagnosis. Then we’ll begin a new riddle for the following month!

Some Guesses as to What the Diagnosis Will Be

“Isn’t 51 kind of early to have osteoporosis? Maybe that’s why Kathy’s fractured toe isn’t healing. Also, she could be in the habit of going to a tanning salon either to use the beds or the creams or both. Where I live on Long Island, lots of girls and women do that even though they could be courting melanoma. And remember that New Jersey woman who was dubbed ‘Tan Mom’ when her story went viral on the Internet? She was accused of taking her five-year-old daughter with her to a tanning salon!”

— Maureen G.

“We learned that Kathy’s weight had gone down. She said she had lost her appetite, but I’m wondering if she could have an eating disorder. Teenagers aren’t the only ones who have disordered eating! My sister starved herself from the time she was about 30 after her jerk of a boyfriend at the time told her she was fat. She also became was a total exercise nut. Her periods stopped, which is called amenorrhea, and she ended up with a stress fracture in her foot. The doctor said she had the classic ‘triad’ – disordered eating, overexercise, and amenorrhea. The happy ending is that she dumped that boyfriend, started eating and exercising normally, got her periods back, met and married a terrific guy, and had two kids in her early 40’s. So I’m a very happy aunt!”

— Lucy M.

“My daughter, who is a sophomore in high school, had to do a report on President John F. Kennedy. She did a really great job of research and one thing she found out was why JFK always had a tan. It wasn’t because he vacationed on Cape Cod! He had a medical secret. At the age of 30, he was diagnosed with a fairly rare autoimmune disorder called Addison’s disease. As I understand it, his adrenal glands weren’t functioning right. Apparently he took medication his whole life. His condition wasn’t revealed until the 1976 bookThe Search for JFK by Joan and Clay Blair. Anyway, my guess is that Kathy has Addison’s disease.”

— Claudia K


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